February 28, 2011

Positive approach key to sex offender change

Trailblazing authors have walked the walk for 40 years

John distorts his offense history and refuses to accept his sexual deviance. Although the other members of his treatment group vigorously challenge him, they are not fully transparent in their own disclosures. The therapist feels stymied. What should she do?

First, she should abandon confrontation and negative labeling. Next, she should race lickety-split for her computer and order a radical new book that will help her succeed as a therapist and also feel better about herself.

The visionary book is Rehabilitating Sexual Offenders: A Strength-Based Approach, written by the team at Rockwood Psychological Services in Canada. Under the leadership of Bill Marshall, a pioneer in the field, the program has successfully treated sex offenders for 40 years. Unlike most sex offender treatment programs, Rockwood has a negligible refusal rate and a negligible dropout rate. Offenders enter therapy, they complete therapy, and when they get out they are very unlikely to reoffend.

Therapist is the key

As psychologists know from the general treatment research, the therapeutic alliance is a primary factor in successful therapy, with more impact than any specific theory or technique. With sex offenders, who are often mistrustful and reluctant to enter therapy or disclose information that may be used against them, the therapist is even more critical, accounting for between 30% to 60% of change.

Like anyone else (only more so), John isn’t going to benefit from confrontation or shaming. Instead of being critical or judgmental, an effective sex offender therapist is empathetic, warm, respectful, and even humorous at times.

Toss out those iatrogenic labels

Language is powerful. When we call people names -- pedophile, rapist, offender, sex offender, deviant – we encourage their negative and harmful beliefs about themselves. That certainly doesn’t reduce shame or foster change.

Inside every offender is a good person waiting to throw off the burden of his dysfunctional past. It is the therapist’s job to facilitate the emergence of that good person.

(Ironically, they do use the term “psychopath,” if only to say that scores on the Psychopathy Checklist are NOT predictive of treatment failure or recidivism. Of the 70 offenders in their outcome research who scored high on psychopathy, only one reoffended during the 8-year follow-up period.)

The authors do not mince words in critiquing the dominant treatment approach that emphasizes deficits and avoidance. When treatment fails, they say, it is most likely because it was too confrontational. When confronted, patients learn to say what the therapist wants to hear, rather than to genuinely engage.

Denial: Not necessarily a bad thing

One of the most unusual features of the Rockwood program is its emphasis on helping men who continue to deny their offenses despite having been convicted. The therapists do not challenge these offenders to admit their crimes. In fact, they don’t think admissions are that big a deal. They offer several reasons for this:

Given what we know from the false-confession literature, some deniers truly are innocent. And it is impossible to know which ones.

Forcing an offender to match his account to his victim’s is silly, because we know from research that victim accounts are highly unreliable.

Men who deny offending or offer excuses actually have lower rates of recidivism. As Shadd Maruna found in his research with criminal offenders in the UK, excuse-making is related to good mental health as well as to guilt, which (unlike shame) suggests prosocial values.

For those engaged in treatment, the manual gives loads of practical advice on how to structure and run a program. For forensic evaluators on the outside looking in, who have watched in mounting horror as iatrogenic practices are systematically mislabeled as “treatment,” this book lays out the research that can help you explain real treatment to judges, jurors, and attorneys.

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The art on this page is by Ricky Romain, an internationally acclaimed human rights artist in the UK whose work focuses on themes of justice, alienation and sanctuary. Mr. Romain has kindly given permission to showcase his art here. I encourage you to check out his extensive online gallery (HERE).

7 comments
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A quibble not not much consequence: Language is powerful. When we call people names -- pedophile, rapist, offender, sex offender, deviant – we encourage their negative and harmful beliefs about themselves. That certainly doesn’t reduce shame or foster change.My impression is that labeling theory comes a lot more out of sociology than linguistics. My suspicion, as a linguist, is that it's not the individual lexical items that are the real issue, or are the major determinants of self-understanding. In this instance, I suspect that more than the specific lexical items, it's the shaming, the confrontational approaches, the treatment of non-PC opinions as "cognitive distortions" (even when these are the dominant positions in many cultures) and everything that this entails, putting a focus on victim empathy, even when there is no victim, and even despite the clear hypocrisy of this being demanded by clinicians who show no empathy for their victims. I think it's much more the ideologies and the day to day practices and experiences that give meaning to those lexical items that's the real issue. I highly doubt that replacing the specific objectionable terms with neutral ones or replacing nouns (sex offenders) with longer, clunkier noun phrases (people who have committed sex offenses) would really fix anything.

Still, specific words are an easy target and an easy matter to reflect on. Embedded in them is a whole ideological framework, and arguing about what words to use can be a useful proxy for the larger ideological issues. As the specific words involved do reflect the ideological frameworks they are embedded in, and do carry evaluative weight, changed ideologies will often require changing vocabulary used.

In terms of debates about lexical choice, I am actually quite skeptical that using certain lexical items (rather than the full discourse with the ideas therein communicated) is really going to have all that strong an effect on how people think about stuff. However, it is often a measure of how I think about stuff, and using one set of words rather another can cause people to categorize me as having this or that ideology, can cause them to judge me, etc.

I'm not sure if the wording is from the book or is yours, but it's interesting that it says above: "Language is powerful. When we call people ... offender, ... we encourage their negative and harmful beliefs about themselves," and then almost immediately after that, the "offender" label is used as routinely as usual: "Inside every offender is a good person waiting to throw off the burden of his dysfunctional past." If we want to help a person throw off the burden of an old conviction, we could start by not calling him or her an "offender."

Even after establishing that "some deniers truly are innocent," we find the "offender" term used again: "Forcing an offender to match his account to his victim’s is silly." If a denier is telling the truth, then he is not an offender, he is a victim of a failed legal system.

I have struggled with this issue of terminology and have decided never again to use the term "offender" to refer to a person. There surely are some people on the registry who would deserve to be called offenders, but our legal system makes it impossible for us to know which ones they are, whether because of false accusations or because of prosecuting teenage lovers, sexters, and streakers.

Although my research website is riddled with the offensive terminology (including in its very title!) and I don't know when I'll get around to fixing it, anything new I write refers to "people on the registry" or "registered persons" instead of "sex offenders."

"Language is powerful. When we call people names -- pedophile, rapist, offender, sex offender, deviant – we encourage their negative and harmful beliefs about themselves. That certainly doesn’t reduce shame or foster change."

The labels have gotten progressively worse over the years, from sex offender to sexual predator to sexually violent predator. The label issue applies to society as a whole. These labels have encouraged the plethora of revenge-motivated sex offender laws.

I'm going to trial in two weeks in a criminal case where a civilly committed sex offender is charged with a felony basically for not admitting the offenses of conviction.I have asked my psychologist to get Marshall's books (both of them). He's familiar with the Mrashalls and their work and whole heartedly agrees.Thanks for this blog. It's great and has been a lot of help.

A subscriber passed along a link to a related column on health from the New York Times: Go Easy on Yourself, a New Wave of Research Urges. As Marshall and colleagues discuss in their book, such advice is especially essential with sex offenders, whose extraordinarily low self esteem is a barrier to therapeutic change.

The (1989) Furby, Weinrott, and Blackshaw study of these studies being the most extensive and meticulously analytical. The studies found that offenders placed on probation with NO therapy are the least likely to re-offend. Offenders sent to jail or Prison also WITHOUT THERAPY are rated second least likely to re-offend. But those who are mandated, volunteer (under threat of prison or jail time) or are sentenced to Behavior Modification therapy are at least twice and as much as ten times as likely to re-offend in the committing of a new sex crime, and will commit other types of violent crimes at unreasonable rates as well.

Does this mean that all treatment programs cause people to re-offend? Maybe, there are some that use a humanistic approach, through self-awareness and self-management. Rather than probe the traumas of the past or desensitize maladapted behavior through behavior modification. One such program was the Child Sexual Abuse treatment program (CSATP) from Santa Clara county, California. According to the (CSATP) data from 1971 to 1982, they treated over 12,000 individuals, both victims and offenders. More clients then any other single agency in its field. Jean M. Goodwin in her book "Sexual Abuse" (1990) stated that the CSATP was rated the best program in the country with a maintained re-offense rate of less than 1%. This, without failing or removing people from the program. From this program, Parents United was started as a support group. Some Parents United programs still follow the original format, sadly, not most. Only through a personal choice can a person change his or her direction in life not by being forced in to it by anyone else. There are programs today in the Department of Corrections that people have chosen to be part of that have lessen re-offense rates for all crimes. Some of them are Chuck Colson's Prison Fellowship for growth in spiritual strength and Christian values. Gordon Graham and Co.'s Breaking Barriers that has offered self esteem training for industry, education, government agencies, the military, labor/management and criminal justice systems in the U.S. and abroad. The seminars provide an awareness of the solutions to problems in positive ways, showing that everyone can win. The original Pathfinders organization in Oregon with their program including modules in team building, communication, problem solving, motivation, life planning and time, anger and stress management. The Pathfinders recidivism rate is less then 2% in 2000. these types of programs have a positive impact on everyone who participate. These programs are successful because they do not worry about the past but look only into changing the now and the future

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Karen Franklin, Ph.D. is a forensic psychologist and adjunct professor at Alliant University in Northern California. She is a former criminal investigator and legal affairs reporter. See her website for more professional background. If you find this blog's content helpful, you may subscribe to its digest version (via "subscribe" box, above) to automatically receive new posts.

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